Re: Health Bulletin

Scientists are developing the first large panel of antibody treatments against the mosquito-borne chikungunya virus.

Chikungunya virus causes a flu-like illness with headaches and fever and then disabling joint pain that can last for years.

Up until now, there has been no effective treatment for the virus infection, and there is no licensed vaccine to prevent it, researchers said.

The development process in Vanderbilt University Medical Center's James Crowe's laboratory works like this: With a few ounces of blood from a previously infected person, researchers find chikungunya antibody - secreting cells, and then those cells are processed to retrieve their DNA and antibody genes.

The team started about two years ago acquiring blood from people who had chikungunya as children and has isolated 3 dozen chikungunya antibodies so far.

"Amazingly even decades after an infection, people still have cells in their blood making antibodies for chikungunya," Crowe said.

In what Crowe calls a "needle in the haystack" technology, his team is able to pull the B-cells (which secrete antibodies) from the blood, and using molecular biology, make antibody drugs.

About 1-2 ounces of blood is taken from each individual who has been infected.

The white and red blood cells are separated and only the white are retained. Once the cells start making antibodies, the cells are pulled out, and the genes are pulled from those.

They are testing in model systems, but the goal is to test one or more of the antibodies in human beings in about a year.

When current laboratory studies identify the very best drugs among the several dozen available, researchers will hand their gene findings over to a drug company for mass manufacturing of the treatments.

Crowe said using antibodies for treatment, and the body's natural immune defence, may be more effective than trying to develop a synthetic drug, which typically has a high rate of failure.

"It's not only a more natural way to make the drugs, it's a more powerful way, because human beings make the most amazing antibodies," he said.

Once the drug is developed and tested in humans, Crowe said it would be given to infected people early in the infection, prior to the debilitating joint pain.

"This would be similar to what you do with flu drugs right now - you develop a fever for a day, you take the test, and take the drug a day or two after," he said.

A vaccine that induces long-term protection could be more convenient and cost-effective in the long run than giving shots of the antibody to try to prevent infection, he said.

Re: Health Bulletin

New drug compound may reduce HIV potency

Researchers have discovered that supplementing existing antiretroviral therapy with a natural compound can reduce the potency of the human immunodeficiency virus (HIV), thereby halting the progression of AIDS.

HIV-infected patients remain on antiretroviral therapy for life because the virus survives over the long-term in infected dormant cells. Interruption of current types of antiretroviral therapy results in a rebound of the virus and clinical progression to AIDS.

"Our results highlight an alternative approach to current anti-HIV strategies," said lead researcher Susana Valente, associate professor at The Scripps Research Institute (TSRI) in the US.

In the study published in the journal mBio, the researchers have detailed that unlike other antiretroviral therapies, a natural compound called Cortistatin A reduces residual levels of virus from the HIV-infected dormant cells, establishing a near-permanent state of latency and greatly diminishing the virus' capacity for reactivation.

"Prior treatment with Cortistatin A significantly inhibits and delays viral rebound in the absence of any drug," Valente noted.

"Our results suggest current antiretroviral regimens could be supplemented with a Tat inhibitor such as Cortistatin A to achieve a functional HIV-1 cure, reducing levels of the virus and preventing reactivation from latent reservoirs," Valente explained.

For the study, the researchers isolated cells from nine HIV-infected participants being treated with antiretroviral drugs.

They found that treatment with the natural molecule reduced viral reactivation by an average of 92.3 per cent.

"These results highlight the need for a more individualistic approach in identifying factors that may increase risk for weight gain," said study lead author Barkha Patel, post-doctoral fellow at Yale School of Medicine in the US.

People vary greatly in their ability to imagine the smell of freshly baked bread or the sweet aroma of a bouquet of roses.

In the study, participants completed a series of questionnaires that asked them to imagine both visual and odour cues and then to subsequently rate the vividness of these cues.

The researchers found that individuals with a higher body mass index (BMI) reported greater ability to vividly imagine food and non-food odours.

The results will be presented at the annual meeting of the Society for the Study of Ingestive Behaviour (SSIB) at Denver, in Colorado.

Re: Health Bulletin

IIT-Kgp devises ‘super stetho’ for lung diseases

Call it the 'super stethoscope'. Its scope goes beyond hearing the heartbeat, though. It turns sound signals from the lungs into digital images, which in turn can be used to detect ailments. IIT-Kharagpur, in collaboration with the Institute of Pulmocare & Research Kolkata (IPCR), has designed this technology to spot lung disorders through images of digitally-processed lung sounds.

The technology is complex but not impossible to understand. In layman terms, most body organs, perhaps all, send out signals. A healthy organ will send out a particular signal, an organ with a specific disorder will send out another and so on. An image is allotted to each signal. After "hearing the lungs", the signal received is converted to a digital image. When compared to the "healthy" image, even an untrained eye can see a difference in case of a disorder.

"Once the device reaches a marketable stage, the image can be sent directly to the medical facility by a smartphone. The likely disorder then would take very short time to diagnose. This would be of immense help to rural health centers once it is ready to be rolled out," said Dr Parthasarathi Bhattacharyya of IPCR.

"Call it an eye to help the ear. We aimed at spotting patterns in the lung sounds. These carry specific signatures of normality and disorder. It is then converted to digital image for identification of the disorder, if any. So far, we have been able to identify only one signature — for interstitial lung disease — which makes the lungs shrink," he added. Two centuries after the stethoscope was invented, this device has already got the patent for the core concept, said professor Goutam Saha of the department of electronics and electronic communication engineering.

Recently, an editorial in the medical journal 'Respirology' published an article under the title 'Seeing what we hear: an eye to help the ear'. It was entirely focused on the new findings of this collaborative research.

"When a doctor uses a stethoscope, the sound of heartbeat sends him a signal. The quadrant tells the doctor that this signal is close this particular disease. He can say, 'Show me a person with the same disease'. It is helpful in finding the most likely disorder affecting the patient and a diagnostic test can be ordered. Here, we are going several steps ahead. Incredibly, the heart sound is filtered and only the lung sound is captured," said IIT director Partha Pratim Chakraborty.

On clinical trial, Saha said that a 20-patient trial has been successful and three doctors had individually verified the findings. On the future course, the IIT director said once it hits the market in a few years, it'll keep upgrading itself, just like a smartphone software. "It'll keep adding digital signatures as more and more are identified," he added.

Re: Health Bulletin

6% TN women still deliver at home, reveals survey

Recent data put out by National Sample Survey Organisation (NSSO) has punctured Tamil Nadu's claim that it has achieved 99.9% institutionalised deliveries. According to NSSO statistics, for every 1,000 women in the age group of 15-49 who delivered last year, 57 (nearly 6%) gave birth at their home.

For a state that boasts of advanced medical care and easy accessibility to hospitals, or at least public health centres, the numbers seem bad as childbirth at home could result in several consequences for the mother and the baby.

Childbirth at home could be potentially disastrous for both mother and baby as it involves a lot of complications, warned senior gynecologist Dr Jaishree Gajaraj. "The mother could suffer from post-partum haemorrhage where she would end up bleeding profusely. Or there could be complications such as obstructed labour or foetal distress which can result in the loss of the baby," she said.

Dr Gajaraj said even if the woman had an obstetrician by her side while she went into labour at home, it may not help much since the complications can easily spiral out of control when there are no good medical facilities.

Doctors Association for Social Equality general secretary Dr G R Ravindranath said childbirth at home still happen in rural and hilly areas where accessibility to hospitals is low. "People still practise unsafe methods like cutting the umbilical cord with unhygienic knives. Though there is awareness about institutional delivery, accessibility remains a problem," he said.

The director of public health Dr K Kolandaisamy, however, said there is no way the survey numbers could be accurate as Tamil Nadu has recorded a 99.9% institutional delivery last year. "There were home deliveries taking place till 2006. But now we have achieved a good institutional delivery rate and our records are proof," he said.

The official said according to state data, there were 23.4% PHC deliveries, 44.4% public hospital deliveries, 32% private hospital deliveries. There was only 1% home births which included deliveries in vehicles, he said.

Non-steroidal anti-inflammatory drugs (NSAIDS), a class of drugs that provides analgesic (pain-killing) and antipyretic (fever-reducing) effects, pose higher risk of heart attacks, which can occur as early as the first week of using these medicines and the risk increases with longer use or higher doses of such drugs, the US Food and Drug Administration (FDA) has said, basing its findings on a comprehensive review over last 10 years.

In India, popular brands of pain killers and fever reducing medicines such as Brufen, Voveran and Meftal Forte are easily available and are often used with self-medication. Experts say though they these medicines are also popular among doctors, there is a need to be cautious while prescribing them.

"US FDA's reiteration of the warning after so many years is very crucial. They must have found more evidence against these medicines to raise an alarm of greater risk," says Dr Anoop Misra, a leading endocrinologist and chairman of Fortis C-DOC hospital for diabetes. According to Misra, though these medicines are very useful, they need to be avoided particularly among those exposed to high risk of heart attacks.

The American regulator has now raised an alarm asking patients and health care professionals to remain alert for heart-related side effects while using pain killers and fever reducing medicines.

"Patients taking NSAIDs should seek medical attention immediately if they experience symptoms such as chest pain, shortness of breath or breathing trouble, weakness in one part or side of the body, or slurred speech," it said.

It has also decided to update the existing warnings on drug labels to indicate that such medicines pose an "increased risk of heart failure".

The risk of heart attack and stroke with pain killers and fever reducing medicines was first described by the US FDA in 2005 when it issued boxed warning on drug labels. "Since then, FDA reviewed a variety of new safety information on prescription and OTC NSAIDs, including observational studies, a large combined analysis of clinical trials, and other scientific publications," said the American regulator, considered the world's strictest watchdog for medicines.

US FDA said though there is a greater likelihood of heart attack or stroke in patients with heart diseases or risk factors after taking NSAID, there are also studies showing that use of these medicines can increase the risk even in patients without any such disease.

Re: Health Bulletin

Re: Health Bulletin

Smoking could raise mental illness risk: Study

Scientists have suggested that smoking may be a factor for developing psychotic illnesses like schizophrenia.

The analysis by researchers from Kings College London, which was published in the Lancet Psychiatry journal, found that people who suffer from psychosis are three times more likely to smoke than the rest.

A new analysis of existing data published in the Lancet Psychiatry journal found.

While this association is nothing new, little research has been conducted into whether smoking could actually be a causal factor for psychosis.

Researchers from Kings College London, who Researchers conducted an analysis of 61 studies comprising data on 15,000 smokers and 2, 73,000 nonsmokers.

Analysing data , conducted around the world between 1980 and 2014, the team found that 57% of people first diagnosed with psychosis were smokers. The researchers also found that daily smokers developed psychotic illness around a year earlier than non-smokers.

They also found that daily smokers who went on to develop psychosis did so on average a year earlier than smokers who developed the illnesses.

It has long been hypothesized that higher smoking rates among psychosis sufferers could be explained by people seeking relief from boredom or distress, or selfmedicating against the symptoms or side-effects of antipsychotic medication.

But if this were so, researchers would expect smoking rates to increase only after people had developed psychosis.

However, the findings failed to prove its causation, with the researchers saying that some of the studies they looked at did not take into account possible confounding factors, such as whether smokers were also regular cannabis users, something psychotic illness is associated with. Researchers suggested a possible explanation for the link could be smoking's impact on levels of the chemical dopamine in the brain, which also plays a role in psychotic illness.

However, Dr James McCabe, clinical lecturer in psychosis studies at the King's Institute of Psychiatry , Psychology and Neuroscience said smoking should be "taken seriously as a possible risk factor" for psychosis and not "dismissed as a consequence of the illness".

Sir Robin Murray , professor of psychiatric research at the IoPPN said: "Excess dopamine is the best biological explanation we have for psychotic illnesses such as schizophrenia. It is possible that nicotine exposure, by increasing the release of dopamine, causes psychosis to develop."

Re: Health Bulletin

New research has confirmed that obesity, type 2 diabetes and even heart diseases can be caused not just by what and how much you eat, but also by how much your ancestors ate.

This has direct bearing on middle classes in developing countries like India because previous generations of now affluent people may have been poorer and their diets would have been much less. This would have programed the body to a certain low level of food intake. This would bring about changes in the genome too, which are called epigenetic changes.

When such persons start eating carbohydrate rich food in much larger quantities, the body is not geared to use it up efficiently, and stores it in forms that lead to obesity.

Although this was demonstrated by Chittaranjan Yajnik of KEM College, Pune several years ago, new research by Anandwardhan Hardikar's team at the University of Sydney and colleagues overseas, Including DYP College, Pune has confirmed this through a 12 year long experiment on rats.

In Hardikar's study, one group of rats was undernourished for 50 generations and then put on a normal diet for two generations. The second (control) group maintained a normal diet for 52 generations. At the end of the study it was found that when the descendants of the first group were exposed to a normal diet, they were eight times more likely to develop diabetes and multiple metabolic defects when compared to the control group.

"Their adverse metabolic state was not reversed by two generations of nutrient recuperation through a normal diet," said Hardikar, according to a University of Sydney press statement. "Instead this newly prosperous population favoured storage of the excess nutrients as fat leading to increased obesity, cardiovascular disease and metabolic risk for diabetes when compared to their 'developed world' counterparts."

It is projected that more than 70 per cent of the global burden of type 2 diabetes will fall on individuals from developing countries by 2030. One of the big reasons behind this could be this inability to cope with sudden increase in dietary intake.

Hardikar said lower Vitamin B12 levels in the undernourished rats could also be an indicator of this trend.

"Human studies from Ranjan Yajnik's group at KEM Hospital in Pune, India have demonstrated that low circulating B12 and high folate levels are associated with insulin resistance and type 2 diabetes."

With increasing migration of populations from developing to affluent countries, there is a need to identify factors that minimise their risk of diabetes and obesity.

"Hopefully further research in understanding the gut microbes, which are major producers of Vitamin B12 in our body, and/or dietary supplementation with Vitamin B12 and other micronutrients, could reduce the risk of metabolic diseases in the coming generations," says Hardikar.